Ga. may follow S.C. in freeing up hospital expansions

COLUMBIA — As South Carolina squirms over its newly suspended regulations on hospital expansions, a spokesman for the Georgia Hospital Association says Georgia could find itself in a similar spot.

Kevin Bloye said there’s a push underway by some physicians to try to weaken the Certificate of Need (CON) program in Georgia.

“We expect CON actually to be right at the top our legislative agenda in 2014 in Atlanta,” he said. “It’s a hot-button issue everywhere. This is not unique to South Carolina.”

The ability of poor and rural communities to maintain access to health services is one element at stake in the debate.

Under the CON program, which most states have, hospitals must apply for a permit in order to build a new facility, add to an existing one, or purchase expensive equipment. A central purpose is to prevent duplicative services from existing in one place, while starving rural and poor communities of accessible facilities.

Medical health and safety standards are unchanged.

After voting last month to sustain S.C. Gov. Nikki Haley’s veto of $1.7 million in operating funds for the CON program, House lawmakers said their decision wasn’t aimed at eliminating the program. After all, the law that requires permits was not repealed. Meanwhile, South Carolina’s health agency has asked the state Supreme Court to weigh in on whether it is required to regulate hospital expansions — even without funding.

Haley’s intentions were clear.

“The Certificate of Need program is an intensely political one through which bureaucratic policymakers deny new health care providers from offering treatment,” argued the Republican governor in her veto message.

“We should allow the market to work, rather than politics.”

In Georgia, the targeting of CON appears to be led by doctors.

Bloye said some physicians are hoping to open multi-specialty facilities in order to cherry pick patients.

“Really, when you’re talking about physicians who want to open these multi-specialty outpatient surgery centers, they’re going after one kind of patient, those with insurance,” he said. “They’re not aiming for Medicaid recipients and uninsured patients. ... It’s very difficult for hospitals to keep their doors open if only providing care to uninsured and Medicaid patients.”

Bloye said the Georgia Hospital Association would like to see South Carolina’s program continue to operate, adding that it has served its intended purpose.

Paul Hinchey, president and CEO of St. Joseph’s/Candler in Savannah, said the health system “strongly supports” the certificate of need process.

“Although St. Joseph’s/Candler currently does not have any pending CON applications, this decision could impact how we invest in services in the future,” he said. “We are hopeful a solution will be found.”

It’s possible CON-regulated Georgia hospitals and communities on the border with South Carolina would suffer a competitive disadvantage, if South Carolina hospitals enjoy free rein to upgrade and add services with no concern for the broader health care landscape. But the S.C. Hospital Association, which supports the regulatory program, said Haley’s action paralyzed the state’s facilities.

Nearly three dozen projects seeking a Certificate of Need are listed as under review in South Carolina. The list includes a $77,000 new Home Health Agency for Aiken County, sought by Augusta’s CareSouth HHA Holdings, and the $1.5 million construction of a freestanding endoscopy only ambulatory surgical facility, sought by Aiken’s Center for Colon and Digestive Diseases.